The Current Role of Surgery in Metastatic Spine Disease: A New Era
The study by Lee et al. is a large retrospective study of 577 patients with spinal metastases treated in South Korea from 2005 to 2010.1 The authors attempted to identify certain key epidemiological and survival variables between the conservatively and surgically treated groups.
The spinal metastases predominantly included lung, liver, and breast/colorectal cancers. The inclusion criteria for surgery included patients with neurological compromise due to tumor and/or intractable pain. Patients with poor general health (as determined subjectively by the physicians), patients with incidental spinal metastases without neurological compromise, and patients who refused surgery were allocated to the conservative treatment group. They identify female gender, use of adjuvant therapy postoperatively (chemotherapy and/or radiotherapy), and postoperative survival as important positive prognostic factors in the surgery group, while presence of preoperative neurological symptoms, significant systemic
- Lee BH, Kim TH, Chong, HS et al. Prognostic factor analysis in patients with metastatic spine disease depending on surgery and conservative treatment: review of 77 cases. Ann Surg Oncol. (2012, In press).
- Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomized trial. Lancet. 2005;366:643–8. CrossRef
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- Wang JC, Boland P, Mitra N, et al. Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction: results in 140 patients. Invited submission from the Joint Section meeting on Disorders of the Spine and Peripheral Nerves. J Neurosurg Spine. 2004;1:287–98. CrossRef
- Ghogawala Z, Mansfield FL, Borges LF. Spinal radiation before surgical decompression adversely affects outcomes of surgery for symptomatic metastatic spinal cord compression. Spine. 2001;26:818–24. CrossRef
- Hsieh P, Risheng X, Sciubba D, et al. Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas: a series of 20 consecutive patients. Spine. 2009;34:2233–9. CrossRef
- Fourney DR, Schomer DF, Nader R, et al. Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg. 2003;98(1):21–30.
- The Current Role of Surgery in Metastatic Spine Disease: A New Era
Annals of Surgical Oncology
Volume 20, Issue 1 , pp 1-2
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